Recently, as part of materials explaining the new version of its health microsimulation model, the Congressional Budget Office issued updated estimates for the number of non-elderly people without health coverage over the past four years. According to the CBO estimates, the number of uninsured people under age 65 rose from 27.5 million in fiscal year 2016 to 28.9 million in 2018, an increase of 1.4 million.
While CBO does not explicitly discuss why the number of non-elderly uninsured increased, its estimates point to some of the key factors. While the number estimated to have been enrolled in employer-based coverage grew by 2.2 million between 2016 and 2018, likely due to the growing economy, growth in Medicaid and CHIP enrollment was stagnant (increasing by only 0.2 million) and the number with individual market coverage fell sharply by 2.6 million, primarily among those purchasing coverage outside the marketplaces.
The CBO estimates provide yet another troubling data point that the historic progress we have made in reducing the ranks of the uninsured among both children and adults is being seriously reversed. For example, last fall, we released a report on how data from the Census Bureau’s American Community Survey show the share and number of children without health coverage nationwide grew in 2017 for the first time since comparable data was first collected in 2008. Moreover, we have noted that Medicaid and CHIP child enrollment has declined by 600,000 over the first 11 months of calendar year 2018, according to administrative data from the Centers for Medicare and Medicaid Services.
CBO is scheduled to release on May 2 its new health coverage baseline projections (2019-2029) so stay tuned for a blog post on the key takeaways.